The landscape of cancer care in England is shifting. As a solicitor specialising in medical negligence, we often see the devastating impact of unanswered questions and "what if". What if a diagnosis had been made six months earlier? What if a patient’s family history had been flagged sooner?

Recent news from the NHS marks a significant step toward answering those questions before they even need to be asked. The launch of the NHS National Inherited Cancer Predisposition Register—a world-first database tracking over 120 genes linked to cancer risk—represents a proactive leap in patient safety.

What is the cancer gene database?

This is a central, national register designed to identify and monitor individuals who carry inherited genetic mutations, such as the well-known BRCA1 or BRCA2 variants, that significantly increase the likelihood of developing certain cancers.

While genetic testing has been available on the NHS for years, the information has often been held locally or within specific clinical genetics services. This new register brings that data together. By creating a single point of reference, the NHS can now "keep tabs" on at-risk individuals, ensuring they are automatically invited for routine screenings and offered preventative treatments as they become available.

This initiative follows the successful implementation of the Lynch syndrome register, which has already helped thousands of people at risk of bowel and other cancers receive the life-saving surveillance they need.

A patient safety perspective: prevent administrative and clinical oversights

In my work at JMW, many of the cases I handle involve a "failure to follow up." A test result is filed away, a referral is missed, or a patient "falls through the cracks" of a complex system.

The National Inherited Cancer Predisposition Register is specifically designed to prevent these administrative and clinical oversights. By centralising risk data, the system moves from a reactive model—where a patient has to remember to ask for a check-up—to a proactive model, where the NHS reaches out to the patient.

From a patient safety standpoint, this is a game-changer. Early detection remains our most potent tool in the fight against cancer. Whether it is prostate cancer, breast cancer, or rarer inherited conditions, catching the disease at Stage 1 or 2, rather than Stage 4, dramatically changes the prognosis and the intensity of treatment required.

Personalised care and precision medicine

Beyond just screening, this database allows for more personalised care. If a patient does develop cancer, knowing their specific genetic profile can help clinicians choose the most effective treatment. Some cancers respond better to specific therapies based on the genetic "fault" that caused them.

This is what the medics call "precision medicine"—tailoring the treatment to the individual rather than using a one-size-fits-all approach. For patients, this means fewer side effects from ineffective treatments and a higher chance of a successful outcome.

What should you do?

It is important to remember that most cancers are not inherited. However, if you have a strong family history of cancer, there are practical steps you can take:

• Discuss your family history with your GP: If multiple close relatives have had the same type of cancer, or if cancer was diagnosed at a young age in your family, mention this to your doctor.

• Keep your contact details updated: As the NHS moves toward automated invitations for screening, ensuring your GP has your correct address and phone number is a simple but vital step.

• Be proactive with screenings: If you are invited for a screening, whether it’s a mammogram, a smear test, or a specific genetic follow-up, please attend. These appointments are the frontline of your personal health security.

• Continue self-checks: Even with the best genetic tracking in the world, you remain your own best diagnostic tool. Be aware of changes in your body, such as new lumps, persistent pain, or changes in bowel habits, and report them promptly.

A new era of accountability and care

The introduction of this register is a welcome development. It demonstrates a commitment to using technology not just for innovation's sake, but for the fundamental purpose of saving lives through better surveillance and earlier intervention.

As a solicitor, I am hopeful that this system will reduce the number of cases where a "missed opportunity" leads to a late diagnosis. For patients and their families, it offers something invaluable: the peace of mind that comes from knowing the system is looking out for them, even before symptoms appear.